This proposal seeks funding for the continuation of the program of research on alcohol and injuries initiated by a FIRST Award, with a special emphasis on alcohol-related drownings. The original FIRST Award sought to: develop better methods to study the role of alcohol in fatal injuries. The research program has successfully developed a comprehensive statewide surveillance system for fatal injuries in collaboration with the Maryland medical examiners' office. This system includes detailed information on alcohol involvement and has been used for a number of descriptive and analytical studies. In addition, the principal investigator has developed a network of collaborative projects with other researchers working on alcohol use in aquatic settings. This proposed research seeks to extend the work on drownings to include a case-control study of serious boating injuries (fatalities and hospitalized cases); Eighty percent of fatalities are due to drownings and 20% to collisions while almost all nonfatal injuries are due to trauma. To date, research has concentrated on non-boat related drownings and found alcohol to be an important risk factor. Descriptive analysis of boating fatalities reveals that alcohol Involvement is also high. However while much attention has been given to drunk driving, drunk boating has been largely ignored. Alcohol may affect not only the initiation of a crash/incident, but also the ability to survive in the water once an event has occurred. Thus the risk of alcohol is likely to be even greater than in other forms of transportation. This proposed research has 2 main and 2 additional aims: 1) conduct an in-depth analysis of serious boating injuries, and 2) conduct a case-control study to determine the risk of alcohol and boating. In addition the study will: 1) examine if certain features of drunk driving such as the designated driver program are applicable on the water, and 2) develop better methods to study,, alcohol involvement in injuries. This study; involves a modification of roadside surveys to the aquatic environment; including questionnaires on alcohol use and breathalizers. It will be conducted in Maryland and North Carolina, two states with high quality data systems. The information from these studies will form the basis for the development of interventions to reduce drinking in aquatic settings and to suggest policy options in another area of transportation where alcohol use is high and actively promoted by manufacturers. An accurate determination of the role of alcohol and boating injuries is also important to determine future prevention efforts on the water.